Solitaire X / Solitaire Platinum
Medtronic Neurovascular
The Solitaire AB/FR device was the first fully retrievable and self-expanding intracranial stent available, originally designed for stent-assisted treatment of intracranial aneurysms. In 2008, one of the first cases was described in the literature where a Solitaire was used to retrieve an intra-arterial thrombus.
Design and Engineering
The Solitaire AB/FR device was the first fully retrievable and self-expanding intracranial stent available, originally designed for stent-assisted treatment of intracranial aneurysms. In 2008, one of the first cases was described in the literature where a Solitaire was used to retrieve an intra-arterial thrombus. Since then, the device passed through several revisions (Solitaire 2 and Solitaire Platinum), leading to the 2019 version Solitaire X, which is probably the most widely used stent-retriever in the world. The Solitaire X is the company’s 4th generation device, featuring an improved delivery system and the Phenom 21 catheter designed for the delivery of all sizes of the Solitaire X system. The design uses laser-cut nitinol with overlapping closed-cell segments and a parametric design; it is fully resheathable for up to approximately 3 deployments.
Sizing Matrix
- Ø×L
- Microcatheter
- Target Vessel
- 3 × 20 mm
- 0.021"
- M2, small vessels
- 4 × 20 / 4 × 40 mm
- 0.021"
- M1 (workhorse)
- 6 × 24 / 6 × 40 mm
- 0.021"
- ICA-T, proximal M1,
- basilar
- The 4 × 40 mm Advantage
- A study demonstrated the usefulness of the Solitaire Platinum 4 × 40 mm stent retriever,
- which led to higher first-pass reperfusion and complete reperfusion rates than the Solitaire
- FR 4 × 20 mm stent or the Solitaire Platinum 4 × 20 mm stent, especially in Solumbra
- technique thrombectomy. Studies have suggested that the length and size of the stentriever
- itself may predict the first-pass effect.
Deployment Sequence
Cross clot with 0.021" microcatheter (MC) over microwire; confirm distal position with lowpressure contrast injection Unsheath device across thrombus (push device / pull MC); allow 3–5 minutes integration time
Inflate balloon guide catheter (flow arrest); apply aspiration at guide ± distal aspiration catheter Withdraw retriever + MC as a unit under continuous aspiration; deflate balloon only after device is fully out
Evidence
Pivotal in SWIFT PRIME and multiple positive RCTs; the comparator standard against which newer retrievers are benchmarked.
Complications and Safety
Incidences of device-related complications have been reported in the literature at between < 1% and 13%; inadvertent detachment is a feared complication when using the Solitaire device and is associated with a poor clinical outcome. ──────────────────────────────────────────────────
Curated external education for the Stent Retrievers family. Media is provided for reference under fair-use/educational terms and credited to its source; it supplements the printed Atlas.
Procedural & preparation videos
Image references
- Solitaire X stent retriever product imagery
Credit: Medtronic · reference-only
Chapter 1
Stent Retrievers in Mechanical Thrombectomy
See all devices and foundational principles in this family.
Overview
Design and Engineering
The Solitaire AB/FR device was the first fully retrievable and self-expanding intracranial stent available, originally designed for stent-assisted treatment of intracranial aneurysms. In 2008, one of the first cases was described in the literature where a Solitaire was used to retrieve an intra-arterial thrombus. Since then, the device passed through several revisions (Solitaire 2 and Solitaire Platinum), leading to the 2019 version Solitaire X, which is probably the most widely used stent-retriever in the world. The Solitaire X is the company’s 4th generation device, featuring an improved delivery system and the Phenom 21 catheter designed for the delivery of all sizes of the Solitaire X system. The design uses laser-cut nitinol with overlapping closed-cell segments and a parametric design; it is fully resheathable for up to approximately 3 deployments.
Sizing
Sizing Matrix
- Ø×L
- Microcatheter
- Target Vessel
- 3 × 20 mm
- 0.021"
- M2, small vessels
- 4 × 20 / 4 × 40 mm
- 0.021"
- M1 (workhorse)
- 6 × 24 / 6 × 40 mm
- 0.021"
- ICA-T, proximal M1,
- basilar
- The 4 × 40 mm Advantage
- A study demonstrated the usefulness of the Solitaire Platinum 4 × 40 mm stent retriever,
- which led to higher first-pass reperfusion and complete reperfusion rates than the Solitaire
- FR 4 × 20 mm stent or the Solitaire Platinum 4 × 20 mm stent, especially in Solumbra
- technique thrombectomy. Studies have suggested that the length and size of the stentriever
- itself may predict the first-pass effect.
Deployment
Deployment Sequence
Cross clot with 0.021" microcatheter (MC) over microwire; confirm distal position with lowpressure contrast injection Unsheath device across thrombus (push device / pull MC); allow 3–5 minutes integration time
Inflate balloon guide catheter (flow arrest); apply aspiration at guide ± distal aspiration catheter Withdraw retriever + MC as a unit under continuous aspiration; deflate balloon only after device is fully out
Evidence
Evidence
Pivotal in SWIFT PRIME and multiple positive RCTs; the comparator standard against which newer retrievers are benchmarked.
Complications & Safety
Complications and Safety
Incidences of device-related complications have been reported in the literature at between < 1% and 13%; inadvertent detachment is a feared complication when using the Solitaire device and is associated with a poor clinical outcome. ──────────────────────────────────────────────────
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